Training family to assist with physiotherapy for older people transitioning from hospital to the community: A pilot randomized controlled trial

<p><strong>Objective:</strong> To investigate the safety and effectiveness of augmenting physiotherapy with family-assisted therapy, to inform a future, fully powered trial.</p> <p><strong>Design:</strong> Parallel pilot randomized controlled trial.</p> <p><strong>Setting:</strong> Transition Care Program.</p> <p><strong>Participants:</strong> Thirty-five older adults with multimorbidity, recently hospitalized, with a mean age of 84.1 years (<i>SD</i> = 6.1 years) and mean Modified Barthel Index of 67.8 units (<i>SD</i> = 19.2 units), and 40 family members.</p> <p><strong>Interventions:</strong> The control group (<i>n</i> = 18) received usual physiotherapy care. The experimental group (<i>n</i> = 17) received usual physiotherapy care and family-assisted therapy from a family member trained by a physiotherapist.</p> <p><strong>Main measures:</strong> Primary outcomes were falls-related self-efficacy measured by the Short Falls Efficacy Scale – International and falls during the intervention period. Secondary outcomes included daily steps, EQ-5D-3L (three-level version of the EuroQoL five-dimensional health-related quality of life questionnaire) and ICECAP-O (ICEpop CAPability measure for Older people), Modified Barthel Index and Modified Caregiver Strain Index.</p> <p><strong>Results:</strong> There were no between-group differences for falls-related self-efficacy. Relative to the control group, the experimental group was observed to have a reduced risk of falling (relative risk = 0.38, 95% confidence interval (CI) = 0.09-1.60) and a reduced falls rate (incidence rate ratio = 0.22, 95% CI = 0.04-1.20) was of borderline statistical significance. The experimental group walked a mean of 944 daily steps more than the control group (95% CI = 139-1748) and had a significant reduction in activity limitation. There were no between-group differences for quality of life or caregiver strain.</p> <p><strong>Conclusion:</strong> Augmenting physiotherapy with family-assisted therapy is feasible for older people transitioning from hospital to the community. A fully powered randomized controlled trial is indicated. </p>